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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416685
Report Date: 03/21/2022
Date Signed: 03/21/2022 03:11:29 PM


Document Has Been Signed on 03/21/2022 03:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:SECRET GARDEN PRESCHOOL, THEFACILITY NUMBER:
444416685
ADMINISTRATOR:ALYSSA NUNEZFACILITY TYPE:
850
ADDRESS:26 FLORIDO AVENUETELEPHONE:
(801) 652-4417
CITY:LA SELVA BEACHSTATE: CAZIP CODE:
95076
CAPACITY:39CENSUS: 29DATE:
03/21/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Alyssa Nunez & Olesya KalinowskaTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Director, Alyssa Nunez, and explained purpose of visit is regarding further investigation of unusual incident reported on 3/9/2022.

Prior to today's inspection, LPA received Childrens Roster (LIC9040) and contact information for children involved in the incident from Site Director via email.

Upon arrival, LPA toured playground structure where unusual incident took place. LPA inquired about tan bark for playground and visibility of netting under the tan bark. Site Director states that parts of playground were dug up for plumbing purposes which may have caused some of the disarray in the netting. LPA and Site Director discussed the netting at the base of the slide as a tripping hazard and the need for tan bark to cushion falls of children. (Note: Lattice was attached to the playground to prevent children from placing their legs through the side due to a child's knee becoming stuck.)

LPA reviewed 4 staff files while at the facility and Owner, Olesya Kalinowska, arrived during that time. All staff present during the unusual incident have teacher education qualifications, mandated reporter certificates, and at least 1 staff member has current CPR/First-Aid. Interviews were conducted with 3 staff who were present during the incident and 1 staff member, Emiko Stuart, no longer works for the facility.

LPA additionally met with Owner and Site Director to discuss possible strategies for preventing children from falling off of slide in the future. Addition of hand guards next to the slide, padding on wood beneath slide, were discussed. Owner states that she is planning to have teachers stand near the playground whenever children are on it to ensure that they are not playing too rough and to improve supervision of children on the playground.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SECRET GARDEN PRESCHOOL, THE
FACILITY NUMBER: 444416685
VISIT DATE: 03/21/2022
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Olesya and Alyssa will follow-up with LPA regarding final decision for possible playground modifications for children's safety by 4/21/2022.

Exit interview conducted with Olesya. As a result of today's inspection, no deficiencies were cited. Further review is still required for compliance with all Licensing regulations.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022
LIC809 (FAS) - (06/04)
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